Introduction: Previous studies demonstrated an increased risk of preeclampsia in pregnancies achieved by oocyte donation (OD) as well as in pregnancies in advanced maternal age. Yet, this association was studied by comparing OD to autologous oocyte- in vitro fertilization (IVF) pregnancies, rather to natural conception pregnancies.
Aim: To evaluate the rate of preeclampsia in advanced aged women who conceived through donated oocytes compared with natural conceptions.
Material & Methods: A historical prospective cohort study was conducted between the years 1995-2012. Included were 405 singleton pregnancies resulting in live births of parturients aged 45 and over. 270 pregnancies were achieved naturally and 135 women conceived by OD. Data was collected from the hospital records of 4 medical centers. Multivariate analyses were employed to assess the adjusted risks for preeclampsia and other adverse obstetric outcomes.
Results: Mean age at delivery for the natural conception and OD groups were 45.7 and 47.8, respectively. Preeclampsia complicated 3 out of 270 (1.1%) natural conception pregnancies and 17 out of 135 (12.6%) OD conceptions. After adjusting for confounders, OD pregnancies were found to be associated with a 12-fold increased risk for preeclampsia (p=0.001). Among OD pregnancies, the risk of preeclamsia was not affected by parity or age, suggesting that the foreign oocyte may play a specific biologic role in the development of this entity.
Conclusions: After the age of 45, OD pregnancies are associated with a substantially increased risk for preeclampsia as compared to natural conception pregnancies. Consequently, preventive treatment and adequate surveillance may be considered.
